A new report revealed this month that most prevalent neurological diseases—which includes migraine, epilepsy and traumatic brain injury, among others—cost the United States an estimated $800 billion per year. Perhaps even more startling is the expectation that these costs will only rise in the coming years as a result of growing elderly population segments. But what about migraine specifically? We dug a little deeper into the report to uncover specific details about the economic burden of the headache condition as well as the implications for you.
Migraine comes with a costly price tag
According to this latest analysis, the economic burden for migraine patients reaches approximately $78 billion per year.(1) That translates to between $8,500 to $9,500 annual cost for people with chronic migraine and more than $2,000 for those with episodic migraine. These figures represent the direct costs of medication, treatment and other health care expenses as well as the indirect costs of lost productivity and wages, disability and other nonmedical purchases. Although lower than other neurological conditions, these are staggering numbers that indicate just how expensive it is to live with and treat migraine.
Indirect costs are a significant portion of the total economic burden of migraine
We should not be surprised to learn that there are significant “hidden” costs of migraine, ranging from job absenteeism to expenses associated with home modifications and everything in between. The percentage of the total economic burden attributed to indirect costs varies, with estimates ranging from 40 percent to as high as 90 percent, and this analysis pegs it at about 70%—or over 54 billion annually. Furthermore, it is hard to quantify the emotional cost of the condition, which is not necessarily reflected in these findings and can include the impact on relationships as well as the public and private stigma faced by many with migraine.
The high cost of migraine care leads to tough choices
This report just reinforces that the financial and emotional cost of migraine can lead to difficult sacrifices. Last year, migraine.com found that nearly two-thirds of people with migraine have avoided medication due to its cost with half of them also taking smaller doses or skipping them completely to ration them. A majority also acknowledged the heavy financial toll that the condition has taken on their family. In addition, people with migraine often have to avoid certain activities or behaviors that may expose them to triggers, and this could negatively affect relationships with friends or family. Professionals who have migraine also face a unique set of challenges; some have chosen to reduce the amount of hours at work, change careers, or stop working altogether. Clearly, the condition can make many feel as though they are caught between a rock and hard place.
Migraine research is still severely underfunded
Of course we already knew this, but this analysis makes specific mention of the funding “crisis” for the top neurological disorders in the United States; it further describes an accelerated federal investment as “desperately needed.” For reference, the National Institutes of Health (NIH) plans to fund $20 million (with an ‘m’) in research for migraines in 2017—by comparison, NIH expects to invest more than $6 billion for cancer and $1 billion for heart disease. Some have suggested that migraine funding should reach in excess of $100 million annually.(2) This lack of institutional research is compounded by the fact that there is also a shortage of certified headache specialists in the U.S. and other trained professionals in the various headache conditions. All these factors add up to significant issues of short- and long-term care and treatment for people with migraine.
Proper diagnosis and preventative treatment remains critical
Migraine remains frequently under- or mis-diagnosed, which not only leads to increasing costs for patients but also can diminish the effectiveness of current prescribed treatments. In addition, one of the key recommendations of this report is the need for better understanding of preventative therapies—such as precision tinted glasses with FL 41 tint and other devices for trigger management—as well as comparisons of current treatments to identify which are most effective. The call-to-action for institutional support in identifying and researching these options is further amplified by the fact that people with migraine try an average 10 different treatments. This shows that the obligation of prevention currently lies primarily on the patient (usually with support from their doctor or specialist), but it is also great to see researchers encouraging health and government leaders to shift that burden a little bit the other way.
1Gooch, C. L., Pracht, E. and Borenstein, A. R. (2017), The Burden of Neurological Disease in the United States: A Summary Report and Call to Action. Ann Neurol.. Accepted Author Manuscript. doi:10.1002/ana.24897.
2Schwedt TJ, Shapiro RE. Funding of Research on Headache Disorders by the National Institutes of Health. Headache. 2009;49(2):162-169. doi:10.1111/j.1526-4610.2008.01323.x.